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169 Cards in this Set
- Front
- Back
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Blood volume:
Males? Females? |
Males: 5-6 liters
Females: 4-5 liters |
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Hematocrit?
Males %? Females %? |
-The percentage of the blood volume that consists of red blood cells
-Males: 42–52% -Females: 37–47% |
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Majority of plasma is made of?
Aslo contains? |
-90% water
-Contains ions (Na+), nutrients, hormones, enzymes, antibodies, wastes, and proteins |
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Three plasma proteins?
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Albumin
Globulins Fibrinogen |
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produced by the liver and provide the osmotic pressure needed to draw water from the surrounding tissue fluid into the capillaries
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Albumin (60-80%)
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Different types of globulins? Where produced? Function?
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alpha, beta, gamma. Alpha, beta are produced by the liver and function in transporting lipids and fat-soluble vitamins and function in immunity
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Specific use of gamma globulins?
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Can be used in viral infections
Example: Hep-A increases pt immunity |
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________, is an important clotting factor produced by the liver.
The fluid from clotted blood, called ________ |
-Fibrinogen
-serum |
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Formed elements?
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Blood cells:
Erythrocytes Leukocytes Platelets |
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each hg molecule consists of four protein chain called ______, each of which is bound to one ______, a red-pigmented molecule that contains iron, the iron group is able to combine with oxygen in the lungs and release oxygen in the tissues
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-globins
-heme |
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_________ produces RBCs during intrauterine life. After birth they are produced in the ________ stimulated by the hormone ________
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-wall of the yolk sac
-red bone marrow -erythropoietin |
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where is erythropoietin
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90% in kidney the rest in the liver
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Function of basophil?
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releases histamine and other inflammatory mediators
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Function of Eosinophils
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allergy and parasitic infection
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The largest leukocytes,
Are phagocytic cells Nucleus: kidney shaped Transform into macrophages |
Monocytes
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___________ release _______ which stimulates constriction of the blood vessels, reducing the flow of blood to the injured area
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platelets release serotonin
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platelets also secrete
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Platelets also secrete growth factors , autocrine regulators.
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Erythropoiesis
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myeloid and lymphoid
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Myeloid tissue is ?
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the red bone marrow of the long bones, sternum, pelvis, bodies of the vertebrae.
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Lymphoid tissue includes ?
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the lymph nodes, tonsils, spleen, and thymus.
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All blood cells originate in
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red bone marrow
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Pernicious anemia
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inadequate amount of vitamin B12
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Aplastic anemia
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due to destruction of the bone marrow may be caused by chemical or by radiation.
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Granulocytes form from _________
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myeloblasts
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Monoblasts enlarge and form _______
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monocytes
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Platelet-forming cells from _______ which break apart into platelets
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megakaryoblasts
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Polyvera? aka?
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aka polycythemia – excess RBCs due to abnormality of bone marrow
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signs and symptoms of polyvera?
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Increased RBC, WBC, platelts pt has spleomegaly (enlarged spleen), hepatomegaly (enlarged liver), vertigo, headache, increased BP (htn), increased hematocrit
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Anemia?
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erythrocyte levels or hemoglobin concentrations are low
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Normocytic anemia
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such as blood loss
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Microcytic anemia
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RBC are small as in iron deficiency
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Macrocytic anemia
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erythrocytes are bigger than normal in Vit B12 or Folate deficiency
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Thrombocytopenia
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Abnormally low concentration of platelets
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Normal red blood cells contain _________.
Abnormal blood cells contain______ and ______ |
-hemoglobin A
-Hemoglobin S and hemoglobin C |
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Spleen collects dead RBC and converts them into
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bilirubin
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What is jaundice?
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increase in biliruben
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Treatment of sickle cell?
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Patients should take folic acid and Antibiotics and vaccines are given to prevent bacterial infections.
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Lymphocytic (or lymphoblastic) leukemia
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affects white blood cells called lymphocytes, it produces large numbers of mature white blood cells (lymphocytes).
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Myelogenous leukemia
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affects white blood cells called myelocytes. It produces large numbers of immature and mature white blood cells (myelocytes).
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Treatment of leukemia?
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chemotherapy, Interferons, Radiation, stem cell transplant
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Interferon used in leukemia? function
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Interferon-alpha (INFa) therapy to slow the reproduction of leukemia cells and promote the immune system's anti-leukemia activity
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Tunica intima?
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composed of simple squamous epithelium
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Tunica media?
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sheets of smooth muscle
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Tunica externa?
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composed of connective tissue
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______ is the thickest tunic in veins
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Tunica externa
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Wide, leaky capillaries found in
spleen, liver… |
Sinusoids
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Is elasticity higher in arteries or veins?
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arteries
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The blood volume contained in the arteries is called the _______
The volume in the veins is called the ________ |
-stressed volume.
-unstressed volume. |
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-are the site of highest resistance in the cardiovascular system.
-have a smooth muscle wall that is extensively innervated by autonomic nerve fibers |
arterioles
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Alpha1-Adrenergic receptors are found on
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the arterioles of the skin, splanchnic, and renal circulations.
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-Beta2-Adrenergic receptors are found on
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arterioles of skeletal muscle.
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capillaries consist of a single layer of endothelial cells surrounded by ______
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basal lamina
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contain the highest proportion of the blood in the cardiovascular system
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veins
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Veins have _______-adrenergic receptors.
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alpha 1
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blood flow velocity is _______ in the aorta than in the sum of all of the capillaries
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higher
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The greater the amount of elastic tissue in a blood vessel, the higher the elastance, and the ______ the compliance
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lower
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The largest decrease in pressure occurs across the _________ because they are the site of highest resistance.
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arterioles
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Aorta mean pressure?
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100 mm Hg
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Arterioles mean pressure?
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50 mm Hg
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Capillaries mean pressure?
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20 mm Hg
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Vena cava mean pressure?
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4 mm Hg
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the difference between the systolic and diastolic pressures
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pulse pressure
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The most important determinant of pulse pressure is
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stroke volume
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Decreases in capacitance, such those that occur with the aging process, cause __________ in pulse pressure.
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increases
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primary htn? aka?
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aka essential htn
htn of unknown etiology |
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Cushing's syndrome
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a condition caused by an overproduction of cortisol (overproduction of all 3 cortext hormones: cortisol, aldosterone, andogrens)
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Hyperaldosteronism? aka?
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aka konns disease too much aldosterone
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Pheochromocytoma
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a rare tumor that causes over secretion of hormones like adrenaline and NA
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Preeclampsia
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a condition related to pregnancy, endothelial dysfunction in the maternal blood vessels
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parathyroidism
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Hyperparathyroidism = hypercalcemia; excess calcium causes over stimulation of smooth muscle = HTN
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reason for headache symptom in secondary htn?
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Meningeal layer is innervated by sensory branch of trigeminal nerve CN5
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Angiotensin-converting enzyme (ACE) inhibitors
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Captopril, Ramipril
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Angiotensin || receptor blockers (ARBs)
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Valsartan
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Calcium channel blockers
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Felodipine, Benidipine
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P-wave length
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usually 0.08 to 0.1 seconds (80-100 ms) in duration.
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the P-R interval length
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normally ranges from 0.12 to 0.20 seconds in duration
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QRS complex length
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normally 0.06 to 0.1 seconds
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QT Interval length
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can range from 0.2 to 0.4 seconds depending upon heart rate
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depolarization/upstroke of SA and AV node is caused by
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inward current of calcium
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depolarization of ventricles, atria and Purkinje fibers
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result of an inward Na+ current.
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slow depolarization of SA node to threshold is by? This is called?
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inward current of Na
If (slow depolarization, produced by the opening of Na+ channels and an inward Na+ current called If). (“f” which stands for funny). |
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conduction velocity is fastest in ______ and slowest in _______
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-purkinjie fibers
-AV node |
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chronotropic
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rate
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dromotropic
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conduction velocity
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inotropic
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force of contraction
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Reentry typically occurs when ?
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when slow-conducting tissue (eg, infarcted myocardium) is present adjacent to normal tissue.
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magnesium deficiency is associated with? so is deficiency of what other ion?
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PVC's
Potassium |
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hypercapnia and hypercalcemia are associated with?
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PVC
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Class 1 agents? Examples?
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Sodium channel blockers
lidocaine, Phenytoin |
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Class 2 agents? Examples
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Beta-1 blockers; decrease conduction through the AV node.
Class II agents include atenolol, propranolol, and metoprolol. |
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Class 3 agents? Effect on conduction velocity? Example?
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Block the potassium channels, thereby prolonging repolarization.
Since these agents do not affect the sodium channel, conduction velocity is not decreased. Sotalol |
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Class 4 agents? Examples?
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Calcium channel blockers.
Class IV agents include verapamil and diltiazem. |
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class 4 agents mechanism?
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They decrease conduction through the AV node, and shorten phase two (the plateau) of the cardiac action potential. They thus reduce the contractility of the heart, so may be inappropriate in heart failure. However, in contrast to beta blockers, they allow the body to retain adrenergic control of heart rate and contractility
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Contractile cells are extremely efficient at extracting oxygen; they extract _______ of the oxygen from the passing blood—about twice the amount of other cells
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roughly 80%
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intrinsic ability of the cardiac muscle to develop force at a given muscle length.
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contractility/inotropism
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ejection fraction? normal value?
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(stroke volume/end-diastolic volume)
normally 0.55 (55%). |
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cardiac glycoside example? effect on heart
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positive inotropic effect
digitalis |
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Increased preload causes an increase in _______ based on the Frank-Starling relationship.
Effect on the pressure volume loop graph? |
-stroke volume
-The increase in stroke volume is reflected in increased width of the pressure-volume loop. |
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Increased afterload refers to an increase in aortic pressure resulting in a decrease in _________.
Effect of pressure-volume loop? |
-stroke volume
-The decrease in stroke volume is reflected in decreased width of the pressure-volume loop. |
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-The decrease in stroke volume results in a ________ in end-systolic volume.
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increase
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The increase in stroke volume results in a _______ in end-systolic volume
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decrease
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Stroke volume equation
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EDV - ESV
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Cardiac output equation
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CO = SV X HR
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Ejection fraction definition and normal value?
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-is the fraction of the end-diastolic volume ejected in each stroke volume.
-is related to contractility. -is normally 0.55, or 55%. |
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Ejection Fraction equation?
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EF = SV/EDV
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When the pressure in the left ventricle rises above _________(which is the pressure in the aorta), the aortic valve opens
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80 mmHg
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The period during which the ventricles empty blood into the aorta is known as the ________
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ejection period.
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The first heart sound is produced (indirectly) by the closure of the AV valves; it is of _____ pitch and of relatively _____ duration.
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-low
-long |
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The second heart sound is produced (indirectly) by the closing of the aortic and pulmonary semilunar valves; this is of _____ pitch and of relatively ______ duration.
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-high
-smaller |
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Cardiac output (CO) definition?
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the amount of blood each ventricle can pump in one minute
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Sympathetic nerve distribution on the heart
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Sympathetic nerves are distributed to SA and AV nodes with more innervation in the ventricles than the parasympathetic
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All stages of atherosclerosis—from initiation and growth to complication of the plaque—are considered __________________________
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an inflammatory response to injury
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atherosclerosis
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nitric oxide
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________ in the plaque produce some enzymes which digest the _______
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-macrophages
-fibrous cap |
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Lead I
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is between the right arm and left arm electrodes, the left arm being positive.
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Lead II
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is between the right arm and left leg electrodes, the left leg being positive.
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Lead III
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is between the left arm and left leg electrodes, the left leg again being positive.
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V1 & V2
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Right Ventricle
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V3 & V4
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Septum/Lateral Left Ventricle
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V5 & V6
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Anterior/Lateral Left Ventricle
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Pain as diagnostic criteria for MI
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Clinical history of ischaemic type chest pain lasting for more than 20 minutes.
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diagnostic criteria rise and fall of serum cardiac biomarkers such as
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creatine kinase -MB fraction and troponin T and I and myoglobin, Lactate
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______ are more specific for myocardial injury
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dehydrogenase
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The _____________which are released within 4–6 hours of an attack of MI and remain elevated for up to 2 weeks
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cardiac troponins T and I
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The following increase chances for developing _______:
-Artificial heart valves -Congenital heart disease (atrial septal defect, patent ductus arteriosus) -Heart valve problems (such as mitral insufficiency). -History of rheumatic heart disease. |
endocarditis
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endocarditis symptoms
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Abnormal urine color
Chills (common) Excessive sweating (common) Fatigue Fever (common) Joint pain Muscle aches and pains Night sweats Nail abnormalities (splinter hemorrhages under the nails) Paleness |
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tests for endocarditis?
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Erythrocyte sedimentation rate (ESR)
Transesophageal echocardiogram |
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endocatditis treatment
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Long-term, high-dose antibiotic treatment is needed to get rid of the bacteria. Treatment is usually given for 4-6 weeks
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mitral stenosis causes
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-Rheumatic fever
-Congenital mitral stenosis |
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mitral stenosis symptoms
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atrial fibrillation
severe pulmonary hypertension right ventricular hypertrophy hemoptysis edema |
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treatment for mitral stenosis
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Cardiac Glycosides: These agents alter the electrophysiologic mechanisms responsible for arrhythmia. Digoxin (Lanoxin)
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Digoxin
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Negatively chronotropic - i.e. slowing the heart rate by decreasing conduction of electrical impulses through the AV node, making it a commonly used antiarrhythmic agent in controlling the heart rate during atrial fibrillation or atrial flutter.
Positively inotropic - i.e. increasing the force of heart contraction via inhibition of the Na+/K+ ATPase pump. |
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The following are causes of ________:
-Mitral valve prolapse -Congenital -Atherosclerosis -Endocarditis -Heart tumors -High blood pressure -Marfan syndrome -Untreated syphilis |
Mitral regurgitation
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% of cardiac output to Cerebral =
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Cerebral=15%
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% of cardiac output to Coronary =
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Coronary=5%
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% of cardiac output to Renal =
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Renal=25%
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% of cardiac output to Gastrointestinal =
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Gastrointestinal=25%
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% of cardiac output to Skeletal muscle =
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Skeletal muscle=25%
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% of cardiac output to Skin =
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Skin=5%
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Regulating of arterial Pressure:
Fast mechanism? Slow mechanism? |
-Fast mechanism: neural, (baroreceptor)
-Slow mechanism: hormonal (renin-angiotensin-aldosterone) |
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Baroreceptors are stretch receptors located ?
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within the walls of the carotid sinus near the bifurcation of the common carotid arteries.
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baroreceptors are most sensitive to changes in __________
Additional baroreceptors in the aortic arch respond to ___________, in arterial pressure |
-arterial pressure
-respond to increases, but not to decreases |
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Decreased stretch decreases the firing rate of the carotid sinus nerve cranial nerve ___, which carries information to the vasomotor center in the brain stem.
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IX
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The set point for mean arterial pressure in the vasomotor center is about ______. Therefore, if mean arterial pressure is less than that, a series of autonomic responses is coordinated by the vasomotor center. These changes will attempt to increase blood pressure toward normal
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100 mm Hg
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Renin is an enzyme released from the _________. Renin's substrate is from the _______ and is formed into __________
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-juxta glomular apparatus
-liver -Angiotensin 1 |
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Angiotensin 1 is inactive and is activated to ________ by ______ in the ________
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-Angiotensin 2
-ACE in the lungs |
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Angiotensin 2 function? degraded by?
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-increases aldosterone concentration and vasoconstriction
-degraded by angiotensinase |
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chemoreceptors are located ?
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are located near the bifurcation of the common carotid arteries and along the aortic arch.
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Decreases in Po2 activate ___________ that produce vasoconstriction, an increase in TPR, and an increase in arterial pressure.
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vasomotor centers in the medulla
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Atrial Natriuretic peptide
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-Receptor-agonist binding
-Inhibits renin secretion, thereby inhibiting the renin-angiotensin system. -Reduces aldosterone secretion by the adrenal cortex. -Relaxes vascular smooth muscle in arterioles and venules |
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In the liver and intestine, the clefts are
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exceptionally wide and allow passage of protein. These capillaries are called sinusoids
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In the brain, the clefts between endothelial cells are
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are exceptionally tight (blood-brain barrier).
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Large water-soluble substances can cross capillaries by
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pinocytosis
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HTN treatment when angiotensin 1 is in excess?
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ACE inhibitor: catopril
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HTN treatment when angiotensin 2 is in excess?
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Angiotensin 2 inhibitor?=: valsartan
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HTN treatment for polycystic kidney disease?
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HCTZ diruetic
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HTN treatment for hypercalcemia?
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calcium channel blocker: benidipine
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HTN treatment for overactive sympathetic
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propanolol
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capacitance (compliance) is directly proportional to ______ and inversely proportional to _______
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-volume
-pressure C = V/P |
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capacitance (compliance) describes ?
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how volume changes in response to a change in pressure
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In coarctation of the aorta, a birth defect in which the aorta is narrowed,
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BP is too high in arch/CNS and too low in femoral artery
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Hyperparathyroidism role in secondary htn?
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increases the calcium reabsorbtion by epithelial cell of small inestine
Increases renal reabsorbtion Removes extra calcium from bone and releases into blood stream Hyperparathyroidism = hypercalcemia; excess calcium causes over stimulation of smooth muscle = HTN |
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Atria, ventricle, purkine systems resting membrane potential?
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-90mV
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Order of ion events in atrial and vetrical muscles?
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Phase 0 - Influx of sodium
Phase 1 - Outward flow of potassium Phase 2 - inward flow of calcium Phase 3 - outward flow of potassium/calcium stops Phase 4 - resting potential reached |
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Order of ion events in SA node?
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Phase 0 - calcium flows in
Phase 3 - repolarization - calcium/potassium flows out Phase 4 - slow depolarization - inward flow of sodium |
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Phase 4 of nodal cell is called?
Phase 1 and 2 of nodal cell? |
-iF = funny current
-Phase 1 and 2 of nodal cell are not present |
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The left ventricle is filled with blood from the left atrium and its volume is about ______ = end-diastolic volume
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140 mL
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The volume that is ejected in ventricular systole is the _________. The volume remaining in the left ventricle at point 3 is about _______ = end-systolic volume.
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-stroke volume
-70mL |
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Once left ventricular pressure decreases to less than left atrial pressure, the mitral (AV) valve opens and filling of the ventricle begins. During this phase, ventricular volume increases to about _______ = the end-diastolic volume.
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140 ml
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